El colesterol total predice la mortalidad intrahospitalaria en pacientes de 70 años o mayores hospitalizados por insuficiencia cardiaca aguda

Abstract

Introduction and purposeLower total cholesterol (TC) levels have been associated with increased mortality In both acute and chronic heart failure (HF) patients. The present study sought to evaluate the impact of TC levels on in-hospital mortality in patients with acute HF aged 70 years or older. MethodsPatients were divided into 3 groups based on TC (mg/dL) quartiles (Q) as follow: Q1 (CT≤125), Q2-Q3 (CT 126-174), Q4 (CT≥175). Multivariate logistic regression analysis was performed to assess the association of each variable with hypocholesterolaemia and in-hospital mortality. ResultsThe analysis included 301 patients with acute HF. The mean age was 79.3±5.5 years, and 51.2% of patients had HF with depressed systolic function, and the most frequent aetiology was ischaemic heart disease (40.9%). Higher C-reactive protein levels, lower levels of serum albumin and haemoglobin, and lower left ventricle ejection fraction were independently associated with hypocholesterolaemia. There 26 deaths (8.6% of the series) during hospitalization. In-hospital mortality decreased in a stepwise fashion with increasing quartile of TC: Q1 14.3%, Q2-Q3 8.7% and Q4 2.7% (P=.04), and was independently associated with higher serum creatinine levels and lower serum albumin and TC levels. ConclusionsLower TC levels independently predict increased in-hospital mortality risk in older patients with acute HF. A higher inflammatory activity, associated with a lower total cholesterol in this clinical setting may explain the inverse relationship between cholesterol and mortality.